Diagnosis and treatment of cannabinoid hyperemesis syndrome

Diagnosis and treatment of cannabinoid hyperemesis syndrome

Clinicians should help patients toward this goal following physiologic stabilization. These help quantify the degree of substance use to build insight and direct referrals. Haloperidol and topical capsaicin have pathophysiologic bases and evidence for use in CHS.

Management of CHS Patients

Techniques like meditation, yoga, or even supportive therapy can help reduce chs syndrome stress and improve overall well-being. It’s about finding healthy ways to chill out that don’t involve lighting up. One idea is that long-term cannabis use might mess with the body’s endocannabinoid system, which plays a role in regulating nausea and vomiting. It’s like overwatering a plant – what’s supposed to help ends up causing harm. Another theory suggests that genetics might play a role, making some people more susceptible to CHS than others.

The Endogenous Cannabinoids (Endocannabinoids)

The most effective treatment during the hyperemetic phase of CHS is the use of hot showers by patients. The effects of this learned behavior are temperature-dependent 6, fast acting 6, but short-lived 6,56,62. Hot showers improve symptoms of nausea and https://ecosoberhouse.com/ vomiting 6,52–56,60,62,68,71, abdominal pain 6,56,71, and decreased appetite 68 during the hyperemetic phase. The precise mechanism by which hot bathing produces a rapid reduction in the symptoms of CHS is unknown. It has been proposed that hot bathing may act by correcting the cannabis-induced disequilibrium of the thermoregulatory system of the hypothalamus 6. Darmani has suggested that cannabis increases the core body temperature while concomitantly decreasing skin temperature thus increasing blood flow to the skin and dissipating excess core body heat 72.

• Opioids, while often prescribed for the patient’s debilitating abdominal pain, are not appropriate for CHS, as they may, in fact, worsen nausea and vomiting.
• More educational campaigns targeting heavy recreational and medicinal cannabis users can help in recognizing and preventing CHS.
• Since there are no laboratory or radiographic examinations that can be used to diagnose CHS, CHS should be diagnosed based on symptoms and patient behaviors.
• CB1 receptors are expressed primarily in the brain and are thought to be responsible for most of the known effects of marijuana use, such as euphoria and appetite stimulation.
• Hot showers improve symptoms of nausea and vomiting 6,52–56,60,62,68,71, abdominal pain 6,56,71, and decreased appetite 68 during the hyperemetic phase.
• With these new products, hospitals saw influxes of CHS, and researchers called for more public health guidance and education for providers.

Pathological bathing behavior

The patient continued to experience symptoms and received a second dose of IV propranolol 1 mg an hour later, whereupon his symptoms stopped completely. The patient could be discharged 4 h later and was counseled to stop smoking marijuana 118. Propranolol is a nonspecific, lipophilic beta-1/beta-2-blocker that has been used to treat CVS, particularly in pediatric patients 119. Studies exploring novel treatments, diagnostic criteria, or the pathophysiology of CHS were also prioritized. People with CHS also tend to have a strong urge to take very hot showers or baths. That’s because hot water can help ease cannabinoid hyperemesis syndrome symptoms like nausea.

Case reports have demonstrated a remission in CHS symptoms upon cessation of cannabis use for extended periods 6,51–54,57,59–62,68,71. Unfortunately, many of these patients relapse upon resuming cannabis 6,59,61,62. It has been suggested that many of these patients increase or continue their cannabis use because of their perception that it Twelve-step program will have beneficial effects on nausea 52. Patient education should therefore be provided with emphasis on the paradoxical nature of the symptoms of CHS.

• Though many patients with CHS may use hot bathing or showering to obtain relief from its symptoms, more than 10% may not exhibit this behavior 60.
• Therefore, limited evidence ratings should not be misconstrued as negative clinical findings but, rather, that there are no higher-level studies to qualify the statement as higher-level evidence.
• People with CHS might also struggle with an electrolyte imbalance, which can harm the heart, kidneys, and other vital organs.